| NPI | 1114227139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 47643) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY TP926) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2019-08-29 |